Monday, July 7, 2008

CMS Physician Quality Reporting Initiative - Breaking down the Resistance

CMS continues to push the Physician Quality Reporting Initiative (PQRI)
which represents the move towards quality measurement and comparison healthcare shopping for consumers. While there are many concerns related to the comparability of data and the different case loads and risks adversity fo different phsycians and thier patient load. But it is the burdensome overhead of collecting data
Participating in the program, established by a 2006 tax bill, will require time, resources and staff-something not all physician practices are willing or able to provide, industry experts say. As a result, the physicians that decline to participate in the CMS' Physician Quality Reporting Initiative will lose out on the 1.5% bonus payment the initiative pays.
That makes for interesting reading given the increasing number of factors to collect
2008 PQRI consists of 119 quality measures, including 2 structural measures. One structural measure conveys whether a professional has and uses electronic health records and the other electronic prescribing.
The measures include:

In Diabetics:
  • Hemoglobin A1c Poor Control in Type 1 or 2 Diabetes Mellitus
  • Low Density Lipoprotein Control in Type 1 or 2 Diabetes Mellitus
  • High Blood Pressure Control in Type 1 or 2 Diabetes Mellitus
In Cardiac Disease:
  • Left Ventricular Systolic Dysfunction (LVSD) - placed on ACE
  • Oral Antiplatelet Therapy Prescribed for Patients with Coronary Artery Disease
  • Beta-blocker Therapy for Coronary Artery Disease Patients with Prior Myocardial Infarction (MI)
  • Heart Failure: Beta-blocker Therapy for Left Ventricular Systolic Dysfunction
You can see the complete list here

Capturing this data can be a burden but imagine if you were able to extract this information using the standard clinical documentation practice of dictation. With the addition of speech understanding and extracting this information to a CDA4CDT document that contains the detailed human readable narrative but is linked to the extracted machine readable semantically interoperable clinically actionable data this point of resistance should diminish and capturing this data should become part of the normal clinical documentation process.

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